CLINICAL RADIOLOGY 359

Book Reviews Quality Assurance in Diagnostic Radiology. By J McLemore.

YB Medical Publishers Ltd. £16.50.

This xs a 216 page book containing 12 chapters. The first gives an account of the need for quality control and gives examples of the cash savings that have been made by reduc- hag the number of repeat films needed. Subsequent sections deal with the making up of chemicals, the dark room, proces- sors and their maintenance, X-ray equipment, cassettes and screens, and silver recovery. In each section examples are given of how the quality of the radiograph can be improved by ensuring tha t each component is functioning properly. Advice is given on how to assess films of poorer quality and how to recognise the causes. Artefact analysis can be dif- ficult, and a detailed procedure is suggested to localise the fault. This is followed by a comprehensive problem-solving guide for each part of the image-forming process. It gives step by step instructions in processor usage, maintenance, and fault finding, and covers all the possible defects in chemistry and components. While most of the instructions are specific to Kodak processors the sequence and methods described are applicable to most of the processors one might use. There are systematic check lists for equipment malfunction and these have been well thought out. Not only do these cover radiographic equipment, but fluorographic, tomographic, cine-radiographic, CT scanners and injectors, and the lists could well be used in a breakdown to pinpoint a fault. A basic stock of test phantoms is described, with details of how to use them, pictures and diagrams of the results of the tests, and the evaluation of these results.

While the text is fairly technical it is still easy to read, and the tables and lists are easy to understand, and although there are a few American terms and spellings these are not obtrusive. I think this book will be useful as a bench book in a department where quality control is just starting, or where the reader would like more knowledge of the possible mal- functions leading to radiographs of inferior standard. Where Immediate engineering services are not available it could save a lot of time by helping to pinpoint equipment faults and in some cases cure them.

J. E. Turner

Forensic Radiology. By K. T. Evans and B. Knight. Black- well Scientific Productions. £ 15.

The 195 pages of this book are divided into eight chapters. There are 11 pages of reference. The first five chapters deal with major topics in forensic radiology, and include the trnportance of species, sex, age and subject identification. Forensic dentistry is dealt with by D. H. Whittaker in Chapter 3. The radiology of gunshot wounds, and other traumatic lesions, some not well known, are dealt with in Chapter 4. Such a traumatic lesion is the CV1 syndrome with tnjury to the vertebral artery. Radiological manifestations of drowning, blast injuries and strangulation are included in the text.

Chapter 5 describes the radiological features of child abuse in detail. The chapters on medico4egal radiology are excellent. The important differences between informed ~ ent, implied consent and expressed consent are stressed.

ico-legal arguments relating to the advisability of X-rays m trauma and pregnancy are presented, as are radiological hazards and their medico4egal significance.

This is a unique book in the British radiological literature. It is dearly and concisely written and easy to read. The radiographs are beautifully reproduced. The list of references is extensive and all are well chosen.

This book can be highly recommended to all those with an interest in this subject and also as a reference book to all radiologists. The authors have managed in a smoothly written text to include great detail in a short space. It would be still more enjoyable if twice the size.

Oscar Craig

Ultrasound in Obstetrics and Gynaecology. Edited by Samuel E. Hershberger, Patricia Ann Athey and Frank P. Madlock. C. V. Mosby Company, St Louis, Missouri, 1981. 283 pp. £35.25.

This short text is divided into three parts, obstetrics, gynae- cology and physics. The obstetric section has chapters on the normal pregnancy including the ultrasound assessment of gestational age and fetal growth, congenital abnormalities, multiple pregnancy, placenta and trophoblastic disease and finally a chapter on invasive procedures.

All these chapters are extremely short and although in part compensated for by extensive bibliographies in places this brevity causes confusion. In particular the relative merits of the various parameters used for the detection of intra- uterine growth retardation could have been more fully explained.

The accuracy and value of ultrasound measurements described in pregnancy are briefly discussed. However, the interpretation of some of the figures quoted is difficult to understand, e.g. in Chapter 5 'the TIUV was a sensitive i n d e x . . , only 7 of 28 were false negatives'

Chapter 6 describes all the congenital anomalies which can be detected prenatally with ultrasound, however, it is not always clear at what stages in pregnancy and with what degree of certainty these diagnoses can be made. The gynae- cology section is not so condensed and much easier to follow. An excellent introduction includes a history of gynaecological ultrasound, indications for ultrasound examination, scanning technique and the different roles of CT and ultrasound of the pelvis. This is followed by chapters on the normal female pelvis, uterine, ovarian and tubal abnormalities and, finally, a separate chapter on the assessment of gynaecological malig- nancy. The ultrasound appearances of pelvic disease are often non-specific and throughout emphasis is placed on inter- pretation of ultrasound findings only in conjunction with other clinical findings. This is particularly well illustrated in the description of ectopic pregnancy.

The quality of illustration is good despite the change from white on black in the first half to black on white in the second. The gynaecological images are particularly pertinent to the text although in Chapter 15, 'ovarian masses', they are perhaps a little repetitive. Illustrative case histories are also used to advantage in the chapters on gestational age and growth retardation.

The final chapter on the physics of ultrasound is excellent but probably rather more than is needed for a book of this size.

In conclusion, yet another book on ultrasound in obstetrics and gynaecology with little to make it stand out from the rest

M. Gowland